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Diagnostic and therapeutic uses of play in the childhood psychoses are described. A play procedure suitable for consultative use with children is outlined, and research relating to identification of subgroups of childhood psychoses is reviewed. Case vignettes are employed to illustrate differential therapeutic uses of play with subgroups.
This research evaluated a videotape modeling intervention for six preschool children who showed low levels of social involvement with peers in natural free-play settings. Observations across 14 weeks gave frequency and topographic data on social interactions and assessment of social involvement in play using the Parten Scale. Simultaneous observation of three children gave data on two comparison children for each target child. A multiple-baseline across-subjects design was used with two data analysis strategies. Averaged group data showed statistically significant increases in both interactions and social involvement in play. Visual analysis of the single-subject data, however, indicated no clear treatment outcome for two children, while four subjects showed a variable increase in social responding after viewing the modeling videotape. Session-by-session variability was a feature of the interaction rate measure for comparison children and for posttreatment phase data for target subjects.
Groups of 30 ADD-H boys and 90 normal boys were divided into 30 mixed dyads composed of a normal and an ADD-H boy, and 30 normal dyads composed of 2 normal boys. Dyads were videotaped interacting in 15-minute free-play, 15-minute cooperative task, and 15-minute simulated classroom settings. Mixed dyads engaged in more controlling interaction than normal dyads in both free-play and simulated classroom settings. In the simulated classroom, mixed dyads completed fewer math problems and were less compliant with the commands of peers. ADD-H children spent less simulated classroom time on task and scored lower on drawing tasks than normal peers. Older dyads proved less controlling, more compliant with peer commands, more inclined to play and work independently, less active, and more likely to remain on task during the cooperative task and simulated classroom settings. Results suggest that the ADD-H child prompts a more controlling, less cooperative pattern of responses from normal peers.
This study assessed the relative influences of approach and avoidance behaviors toward same-sex and cross-sex toys in the play of children with gender identity disorder and in normal boys, normal girls, and psychiatric controls. Three forced-choice situations with toys and three forced-choice situations with dress-up apparel were presented that paired same-sex and cross-sex stimuli, same-sex and neutral stimuli, and cross-sex and neutral stimuli. In the same-sex/cross-sex situation, the gender-disordered group played a significantly shorter time with the same-sex stimuli and a significantly longer time with the cross-sex stimuli than the normal boys and the psychiatric controls, whereas the play patterns of the normal girls fell in between that of the gender-disordered group and the two control groups. Within-groups analyses showed that the normal boys and the psychiatric controls preferred the same-sex toys, whereas the gender-disordered group and the normal girls showed no preference. When the neutral toys were the alternative, avoidance of cross-sex toys appeared to be stronger than the attraction to same-sex toys in the normal boys and in the psychiatric controls. The relative influence of approach-avoidance tendencies was more equivocal in the gender-disordered group, though they appeared to have a weaker attraction to same-sex toys and less avoidance of cross-sex toys in comparison with the normal boys and the psychiatric controls. The approach-avoidance patterns of the normal girls fell in between that of the gender-disordered group and the other two control groups.
This study is the first experimental demonstration of sex-typed play behavior change in a young girl with sexual identity disturbance. The 8-year-old child was treated with a self-monitoring procedure combined with a behavioral prompting technique that was gradually faded out. Self-monitoring in the clinic resulted in a high, stable rate of appropriate sex-typed play, and this effect generalized to a different set of sex-typed toys over time. The treatment effects did not generalize to the home environment. The self-regulation intervention was subsequently adapted to the home setting, resulting in a replication of the treatment effects across settings. After the removal of the self-monitoring interventions, a high level of feminine sex-typed play persisted. Pretreatment, posttreatment, and follow-up psychological testing demonstrated a reversal of a pronounced cross-gender identity to a normal female sexual identity.
Infant hand-use preferences are related to mother's, but not father's, handedness. Since infants match mother's hand-use during toy play, maternal handedness can affect infant hand-use. Twenty-eight mother-infant pairs (14 left-handed and 14 right-handed infants but all right-handed mothers) were videotaped while playing with six toys on the infant's 7-, 9-, and 11-month birthdays. Play was analyzed for five kinds of hand-use biasing situations, but maternal hand-use was the dominant influence. Infant matching of maternal hand-use increased with age and right-handed infants and female infants matched maternal hand-use more frequently. Concordance of hand-use preference between mother and infant seemed to account for both the matching and the stronger preferences of the right-handed compared to the left-handed infants.
Gender-disturbed children (n = 14) were compared to their preadolescent siblings (n = 16) and psychiatric controls (n = 13) on a sex-typed free-play task previously shown to differentiate gender-disturbed boys from normal boys. On three separate trials totaling 20 minutes, the gender-disturbed children played for a significantly longer period of time with cross-sex toys and for a significantly shorter period of time with same-sex toys than did the two control groups. The gender-disturbed children also showed greater trial-to-trial consistency in their play preferences than the other two groups. The utility of this task in the assessment of childhood gender disturbance is discussed. In addition, the results are discussed in relation to a number of perspectives regarding both typical and atypical gender identity development in childhood.
Data from lower mammals suggest a masculinizing or defeminizing influence of pre- or perinatal diethylstilbestrol (DES) exposure on various aspects of the sex-dimorphic behavior (including juvenile rough-and-tumble play) of genetic females. However, three previous studies on childhood play and adult gender-role behavior in human females have led to ambiguous results. In a follow-up study of 60 women with prenatal exposure to DES and 26 controls, we used psychometrically well-designed multi-item scales based on self-report inventories for the assessment of these aspects of behavior. No effects of DES could be demonstrated. We conclude that, at the doses studied, prenatal DES exposure in human females has not led to behavioral masculinization or defeminization of childhood play and adult gender-role behavior.
The relationship of play behavior to cognitive functioning in preschool developmentally disabled children was studied by comparing performance on Lowe and Costello's Symbolic Play Test (SPT) with that on the Bayley Scales and Stanford-Binet Scale. Subjects were 247 children referred for evaluation to a hospital-based child development clinic. Subjects were classified as mildly retarded, moderately retarded, atypical, borderline, and language disordered. Correlations between the Bayley/Binet and SPT for the whole sample were significant and in the low to moderate range. Correlations between cognitive and play measures for each clinical group were in the low to moderate range, except for atypical children where the correlations were negligible. The retarded and borderline groups achieved similar mental ages on the Bayley/Binet and SPT, but the language-disordered and atypical groups demonstrated marked differences in their Bayley/Binet and SPT functioning. Implications for using the SPT in clinical practice were discussed.
This study investigated the unique contributions of joint attention, imitation, and toy play to language ability and rate of development of communication skills in young children with autism spectrum disorder (ASD). Sixty preschool-aged children with ASD were assessed using measures of joint attention, imitation, toy play, language, and communication ability. Two skills, initiating protodeclarative joint attention and immediate imitation, were most strongly associated with language ability at age 3-4 years, whereas toy play and deferred imitation were the best predictors of rate of communication development from age 4 to 6.5 years. The implications of these results for understanding the nature and course of language development in autism and for the development of targeted early interventions are discussed.
This study describes a longitudinal design (following subjects described in Rutherford & Rogers [2003, Journal of Autism and Developmental Disorder, 33, 289-302]) to test for predictors of pretend play competence in a group of children with autism. We tested the hypothesis that developmental change in pretend play performance can be predicted by earlier measures of either executive function, intersubjectivity, imitation, or general development. Participants at the time of follow-up testing were 28 children with autistic disorder (mean chronological age (CA) 57.6 months), 18 children with other developmental disorders (mean CA 59.0 months), and 27 typically developing children (mean CA 30.1 months). Children with autism were profoundly delayed given both competence (prompted) measures as well as performance (spontaneous) measures. Joint attention at time 1 strongly and uniquely predicted pretend play development.
The view of a triad of impairments [(Wing and Gould (1979). Journal of Autism and Developmental Disorders, 9, 11-30] in which impaired imagination is linked with repetitive behaviour is widely accepted. However this categorisation differs from the international classification systems, which link imagination to communication impairments rather than to repetitive behaviours. To investigate this relationship, the Activities and Play Questionnaire-Revised was completed by 196 parents of 2-8-year-old children with autism spectrum disorders (ASD) and typical development. Results showed that repetitive behaviours were associated with play in ASD but not in typical development, supporting Wing and Gould's triad. However there was also an association between play, repetitive behaviour and language, confirming the international classification systems description of imagination as a component of language and communication difficulties.
In an exploration of Istomina's (1975) paradigm contrasting children's recall from an involuntary or game-like context with recall from an intentional or lesson-like context, this study investigated the relative efficacy of asking 4- and 5-year-olds "to remember" or "to play with" a set of 16 pictures or toys in a naturalistic or laboratory setting. The children's behavior and language were measured during two 2-min study phases, after which recall was assessed. Toys promoted different study phase activities and better retention than pictures, asking a child "to remember" a set of toys led to less recall than asking the child "to play" with the toys, and, across all conditions, instructions "to play" and "to remember" elicited differentiated study phase responses but similar levels of retention.
The paper describes a portable electronic device which automatically records a measure of object play behaviour, by counting the number of contacts made with a play manipulandum. The device is designed for recording a measure of object play in domestic cats, but is readily adaptable for use with other species.
Play behavior of blinded and sighted juvenile rats was measured using the brief paired-encounter procedure. Dyads of sighted-sighted, blind-blind, or sighted-blind rats were observed in a large or small chamber on alternate days for ages 28 through 43 days. Blinded rats played as frequently as sighted rats regardless of pair composition or chamber size. Vision is not essential for initiating or maintaining play fighting.
The social play of juvenile rats was observed following administration of either the alpha-2-adrenergic agonist clonidine (0.1, 0.5, 1, 5, 10, and 50 micrograms/kg) or antagonist yohimbine (0.5, 1, 2, and 5 mg/kg). Using pins (one animal on its back with the other on top) as the dependent measure, we found that clonidine reliably reduced the amount of play at all but the lowest dose tested, while yohimbine had no effect at any but the highest dose. In addition, we tested a clonidine-yohimbine interaction to assess neurospecificity of the results. While yohimbine alone (0.5 mg/kg) had no effect on play, it partially reversed the clonidine-induced suppression, indicating that the effect may be mediated to some degree through an alpha-2-adrenergic mechanism.
Anatomical dolls are used to facilitate children's explanations of sexual abuse. The goal of this study was to identify whether children referred for evaluation of possible sexual abuse would react differently to dolls than would nonreferred controls matched on sex, race, and age. A sample of 35 two- through six-year-olds referred to a hospital child abuse clinic were compared to 35 controls. After a rapport-building exercise, each child played under four conditions in a specially prepared room. Two coders, unaware of the child's group membership, viewed each videotaped session and completed separate behavioral checklists. Six conclusions resulted: (1) anatomical dolls did not create undue anxiety; (2) careful interpretation of sexualized play with dolls is needed; (3) dolls did not overstimulate and cause demonstration of sexual activity; (4) sexual abuse could not be diagnosed solely on the basis of doll play; (5) children in both groups inserted their fingers into doll openings; and (6) practitioners must rely on supporting verbal and physical evidence when making the determination of possible sexual abuse. More training and comfort with anatomical dolls and knowledge of normal child development principles are needed by examiners.
A study of morbidity and mortality in a peasant village in Nepal describes chronic malnutrition and endemic infectious disease. More than one-third of village children between the ages of 1 and 5 die. Those who survive apparently pursue a spontaneous strategy of maximizing their physical growth potential by minimizing the expenditure of energy in play. This raises the possibility that psychological, social and motor development is impaired. It is found, however, that while less time and energy is devoted to play, the pattern of play that does occur is similar to that of healthier peasant children in other times and places. It is therefore probable that maturational levels of attainment are not impaired, but it is urgent that this assumption be further investigated.